In patients with a history of COVID-19 infection, increased risk for cardiovascular disease (CVD) and mortality have been reported in the acute phase, according to findings from a prospective cohort analysis published in Cardiovascular Research.
Researchers sought to assess the short- and long-term associations between COVID-19 and development of CVD outcomes and mortality in the general population. They identified a cohort of patients from the UK Biobank database with a COVID-19 infection between March 16, 2020, and November 30, 2020, and followed these individuals for up to 18 months. Each patient was randomly matched based on age and sex with up to 10 participants without COVID-19 infection from 2 cohorts, a contemporary cohort (from March 16, 2020, through November 30, 2020) and a historical cohort (from March 16, 2018, through November 30, 2018).
Characteristics between the groups were further adjusted with the use of propensity score-based marginal mean weighting via stratification. Cox regression analysis was used to establish the association of COVID-19 with CVD and mortality within 21 days of diagnosis (the acute phase) and following this period (the post-acute phase).
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The acute phase of the study comprised a total of 7584 patients with COVID-19, who were matched with 75,790 contemporary control patients and 75,774 historical control patients. The post-acute phase of the study included a total of 7139 patients with COVID-19, who were matched with 71,296 contemporary control patients and 71,314 historical control patients.
Results of the study showed that in the acute phase, patients with COVID-19 exhibited a significantly higher short-term risk for CVD (hazard ratio [HR], 4.3; 95% CI, 2.6-6.9; and HR, 5.0; 95% CI, 3.0-8.1) and all-cause mortality (HR, 81.1; 95% CI, 58.5-112.4; and HR, 67.5; 95% CI, 49.9-91.1) compared with the contemporary control patients and the historical control patients, respectively.
Further, in the post-acute phase, patients with COVID-19 persisted with exhibiting a significantly higher risk for CVD in the long-term (HR, 1.4; 95% CI, 1.2-1.8; and HR, 1.3; 95% CI, 1.1-1.6) and all-cause mortality (HR, 5.0; 95% CI, 4.3-5.8; and HR, 4.5; 95% CI, 3.9-5.2) compared with the contemporary control patients and the historical control patients, respectively.
Limitations of the study include lack of applicability to other ethnicities and age-groups, as well as the lack of information on several confounders, including lifestyle characteristics, clinical factors indicative of disease severity, and history of medication use.
“These risks remain increased even up until a year post recovery and are associated with long-COVID,” the study authors wrote. “Ongoing monitoring of signs and symptoms of CVD in the short- and long-term may be beneficial in patients post infection and recovery.”
Disclosure: Some of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Reference
Wan EYF, Mathur S, Zhang R, et al. Association of COVID-19 with short- and long-term risk of cardiovascular disease and mortality: a prospective cohort in UK Biobank. Cardiovasc Res. Published online January 19, 2023. doi:10.1093/cvr/cvac195
This article originally appeared on The Cardiology Advisor
